Although medical equipment maintenance has been carefully managed for years, very few in-depth studies have been conducted to evaluate the effectiveness and efficiency of these implemented preventive maintenance strategies, especially after the debate about the credibility of manufacturer's recommendations has increased in the clinical engineering community. Facing the dilemma of merely following manufactures maintenance manual or establishing an evidence-based maintenance, medical equipment maintenance could have exploited an advanced area in operations research which is maintenance optimization research. In this paper, we review and examine carefully the status of application oriented research on preventive maintenance optimization of medical devices. This study addresses preventive healthcare maintenance with a focus on factors influencing the maintenance decision making. The analysis is structured by defining different aspects necessary to construct a maintenance optimization model. We conclusively propose directions to develop suitable tools for better healthcare maintenance management.

Purpose The purpose of this paper is to review maintenance strategies within the healthcare domain and to discuss practical needs as gaps between research and practice. Design/methodology/approach The paper systematically categorizes the published literature on clinical maintenance optimization and then synthesizes it methodically. Findings This study highlights the significant issues relevant to the application of dependability analysis in healthcare maintenance, including the quantitative and qualitative criteria taken into account, data collection techniques and applied approaches to find the solution. Within each category, the gaps and further research needs have been discussed with respect to both an academic and industrial perspective. Practical implications It is worth mentioning that medical devices are becoming more and more numerous, various and complex. Although, they are often affected by environmental disturbances, sharp technological development, stochastic and uncertain nature of operations and degradation and the integrity and interoperability of the supportability system, the associated practices related to asset management and maintenance in healthcare are still lacking. Therefore, the literature review of applied based research on maintenance subject is necessary to reveal the holistic issues and interrelationships of what has been published as categorized specific topics. Originality/value The paper presents a comprehensive review that will be useful to understand the maintenance problem and solution space within the healthcare context.

Clinical engineering departments have to establish and continuously regulate a Medical Equipment Management Program (MEMP) to ensure a high reliability and safety of their critical medical devices. Asset criticality assessment is an essential element of reliability centered maintenance and risk-based maintenance, especially when enormous various devices exist and the worst failure consequences are not evident. This paper presents a new risk-based prioritization framework for maintenance decisions. We propose a Multi-Expert Multi-Criteria decision making (MEMC) model to classify medical devices according to their criticality and we describe how obtained scores are used to set up guidelines for appropriate maintenance strategies.

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